Provider Demographics
NPI:1598992869
Name:GRIFFIN, KATHERINE (RDH)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2832 ELDORADO PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7439
Mailing Address - Country:US
Mailing Address - Phone:214-618-5311
Mailing Address - Fax:
Practice Address - Street 1:2832 ELDORADO PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-7439
Practice Address - Country:US
Practice Address - Phone:214-618-5311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11720124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist